The three way bladder catheter is used in the post-operative treatment of bladder or prostate surgery to drain bladder and/or prostate bleedings, respectively. It is provided with a triple lumen branching in three distinct ways at a first end. A second end of the catheter is provided with an inflatable balloon, which represents the end of the second way, while the first and the third ways are open at both the ends of the catheter. The second end of the catheter is introduced in the urethra up to the bladder and anchored thereto conveying the saline solution in the balloon through the second way of the catheter. The continuous urine and blood flow out of the body of the patient from the bladder occurs through the first way of the catheter which, to such aim, is connected to an urine collection device, typically an urine collection bag.
To carry out a bladder “automatic” continuous washing, called “cystoclysis”, a washing liquid coming from a respective supplying system is conveyed thereto through the third way of the catheter to which such system is connected.
To guarantee the complete drainage of the coagula present in the bladder, to des-obstruct the bladder catheter and to avoid the occlusion of the respective first way, it is also needed to carry out periodically another procedure, called “cystolusis”. This last one provides a plurality of consecutive washings of the bladder, typically carried out manually by the operator. To carry out the cystolusis, the operator has to wear: mask, disposable gloves, white coat and safety glasses. In addition it is to arrange a sterile disposable cloth between the legs of the patient; to position a sterile basin thereon; to disconnect the urine collection device connected to the first way; to lean the first end of the catheter on the basin; to throw away the urine collection device; to throw away the disposable gloves; to wash ones hands; to wear sterile gloves; to hold the catheter with the not dominating hand and to practice the des-obstructing washing with the dominant hand by carrying out the following operations cyclically: to suck the saline from the bottle by means of a cone syringe/sterile catheter; to join the syringe to the first way of the catheter; to inject the saline at low pressure in said first way through the syringe; to suck, by means of the syringe, the drainage liquid and coagula; to disconnect the syringe from the catheter and to throw the discarded aspirate in the basin up to the complete drainage of the coagula and/or des-obstruction of the catheter. After that it is needed to throw away the dirty gloves and to wear new clean ones; to connect a new urine collection bag to the first way of the catheter; to throw all the disposable material used in the special waste container; to disinfect and to sterilize the basin; and finally, to remove the individual protection devices or “IPD” used and to throw them away in the suitable special waste container, if contaminated, or in the urban waste, if not contaminated.
Therefore, the cystolusis, when carried out as above described, implies the interruption of the sterile hydraulic circuit system used for the cystoclysis with consequent risk of urinary tract infections onset (called “UTI”). These last ones imply the interruption of the healing process of the patient with worsening of the clinical picture, lengthening of hospitalization times and use, when possible of suitable antibiotics chosen on the basis of the type of bacteria causing the infection. Such antibiotics can be also particularly expensive. Moreover, some types of bacteria cannot be eradicated (for example Klebsiella Pneumonie).
In addition, the interruption of the sterile circuit implies a high biological risk for the operator. In fact, he can be contaminated by coming in contact to urine, washing liquid and blood.
Moreover, it is to be considered that to guarantee a good patency of the bladder catheter, the “cystolusis” is carried out normally at least three times a day, and in case of macrohaematuria or of obstructions of the first way, generally it is regularly repeated more than three times. Therefore, high costs result connected to the cystolusis per se, due to the performance costs, the materials and the disposable IDP and the disposal of the corresponding waste, and above all, to the UTI related thereto. In case of severe haematuria, also the third way of the catheter can be obstructed. Therefore, the steps above described in relation to the des-obstruction of the first way of the catheter have to be repeated by joining the syringe to the third way of the catheter instead to the cited first way. Obviously, this implies that the procedure relative to the cystolusis becomes longer with consequent increase in biological risks for the operator and discomfort of the patient.